“Sustain Controversy”

PM’s secret method of recruiting so-called independent scientists for the project is laid out in various documents. One is BAT scientist Dr Sharon Boyce, who attended a “special meeting” on London in 1988:³

The Philip Morris philosophy of ETS was presented. This appeared to revolve around the selection, in all possible countries, of a group of scientists either to critically review the scientific literature on ETS to sustain controversy, or to carry out research on ETS. In each country a group of scientists would be carefully selected, and organised, by a national coordinating scientist.³

“No previous connections with tobacco companies”

The scientists:

“should, ideally, according to Philip Morris, be European scientists who have had no previous connections with tobacco companies and who have no previous record on the primary health issue which might … lead to problems of attribution. The mechanism by which they identify their consultants is as follows: they ask a couple of scientists in each country … to produce a list of potential consultants. The scientists are then contacted by these coordinators or by the lawyers and asked if they are interested in problems of Indoor Air Quality: tobacco is not mentioned at this stage. CV’s are obtained and obvious “anti-smokers” or those with “unsuitable backgrounds” are filtered out…”³

Philip Morris then expect the group of scientists to operate within the confines of decisions taken by PM scientists to determine the general direction of research, which apparently would then be ‘filtered’ by lawyers to eliminate areas of sensitivity.³

Boyse’s notes include a list of 18 scientists, mostly at British universities, who were suggested as possible consultants.³

“Instead of Second-Hand Smoke, What about Pet Birds as a Cause of Cancer?”

By 1990, Covington and Burling boasted of its successes of the Whitecoat project.⁴ “One consultant is an adviser to a particularly relevant committee of the House of Commons”.⁴ Another was recruited as an editor of the Lancet.⁴ A third was “providing medical advice to Middle eastern Governments”.⁴ One other consultant conducted “research into factors other than passive smoking that cause lung cancer – keeping pet birds”.⁴⁵

Tobacco Tactics Resources

• Influencing Science
• Philip Morris International

References

The post Influencing Science: The Whitecoat Project appeared first on TobaccoTactics.

• For example, internal industry documents show that in the 1960s tobacco companies were aware that nicotine was an addictive substance,⁶ but despite this, in 1994 Brown and Williamson’s CEO testified before the US Congress that nicotine was not addictive.⁷
• In the 1970s seven tobacco companies used national manufacturers’ associations to promote controversy around the idea that smoking was harmful to health – a conspiracy named ‘Operation Berkshire’ – which damaged tobacco control efforts around the world.⁸
• In the 1980s scientists working for British American Tobacco (BAT) were advised by scientists working for Brown & Williamson “about areas of research such as inhalation that should not be further pursued”.⁹

The following are a selection of further historical and contemporary examples of tobacco industry attempts to influence science.

For an overview of the strategies tobacco companies employ to influence science visit the Influencing Science landing page. In each section below, we also link directly to the relevant strategies on the landing page, and to other pages with detail on the examples given here.

Examples of the use of third parties

Tobacco companies often disseminate their scientific messages using third parties. For more on this strategy see the landing page section: Influence the reach of science to create an “echo chamber” for industry’s scientific messaging.  See also the general page on Third Party Techniques.

• Tobacco Industry Research Committee. In the early 1950s, public relations (PR) firm Hill & Knowlton advised tobacco companies on the best way to fight against the emerging evidence of the link between smoking and cancer. Instead of denying the findings of the research, they advised companies to say that more research was needed, thereby creating doubt.¹⁰ It was under Hill & Knowlton’s advice that the Tobacco Industry Research Committee was established. Rather than explore the relationship between smoking and cancer this group looked for alternative explanations for the causes of cancer.¹⁰
• Duke University has a history of collaborating with tobacco companies, including receiving funding from Philip Morris to establish the Center for Smoking Cessation Research (CSCR).¹¹ The Director of CSCR (up until 2022),¹² Jed E. Rose, sat on the advisory board of Philip Morris’ (US, now Altria) “Smoker Cessation Support Initiative”.¹³¹⁴ He also founded the Rose Research Center,¹⁵ and has received funding from the Philip Morris International (PMI) funded Foundation for a Smoke-Free World (FSFW).¹⁶ FSFW is a US based charitable organisation established in 2017 with a grant from PMI, and since then exclusively funded by PMI. One of FSFW’s three main grant themes is Health and Science Research.¹⁷ Research by the University of Bath’s Tobacco Control Research Group (TCRG) found that the Foundation functions as a scientific lobby group promoting tobacco industry interests.¹⁸ See also Foundation for a Smoke-Free World Grantees.

• To explore the scientific research outputs of FSFW and its grantees visit the Foundation for a Smoke-Free World: Research Database

• The Center for Indoor Air Research (CIAR) was created by the industry in the late 1980’s to create doubt about the health risks of second-hand smoke.¹⁹
• The European Science and Environment Forum (ESEF) was active between 1994 and 2005 as a UK-based tobacco industry funded “science watchdog” that conducted a variety of science influencing activities including trying to undermine the science of second-hand smoke, describing it as “junk science”.²⁰
• The Institute of Economic Affairs (IEA) is an influential UK ‘free-market’ think tank that has collaborated with the tobacco industry. Roger Bate, co-founder of the European Science and Environment Forum and lead of the IEA’s Environment Unit published a book in 1996 which was funded by BAT. The book suggested that scientists were overestimating the risk of second-hand smoke.²¹ For more information visit IEA: Working with RJ Reynolds, BAT and Philip Morris on Environmental Risk.

Examples of concealing involvement in science

Tobacco companies covertly fund science so that research appears to be independent from the industry, whilst serving its aims. For more on this strategy visit landing page section: Influencing the conduct and publication of science.

• In the late 1980s Philip Morris developed a covert plan named the Whitecoat Project that involved funding apparently independent scientists to “resist and roll back smoking restrictions” and “restore social acceptability of smoking”.²²
• Ghost-writing is the practice of writing books, reports or research credited to another person. Ghost writers have been employed by tobacco companies as a science influencing tactic. For examples and more information see Influencing Science: Ghost Writing.
• In an attempt to counter the influence of corporate funding on scientific publishing, many journals require authors to submit conflict of interest (COI) statements or funding declarations. In some cases, researchers funded by the tobacco industry fail to declare conflicts of interest. This avoids scrutiny or rejection of their papers, and means industry-funded science can be presented as independent. For example, some researchers that receive grants from the PMI funded Foundation for a Smoke-Free World have failed to declare this conflict of interest when publishing tobacco related science.²³ This is a practice that has in some cases led to the retraction of papers.²⁴²⁵

Examples of industry influencing the evidence base

Tobacco companies attempt to shape the conclusions of research to be more favourable to the industry. There are several examples of Philip Morris employing such strategies, these can be found on Influencing Science: Philip Morris changing the conclusions of research.

Recently, tobacco companies have been spending large sums on research around newer nicotine and tobacco products. Concerns have been raised about the integrity and robustness of this science.

• A 2022 Cochrane review in the UK found that all randomised control trials of HTPs were tobacco company funded and that there was a need for independent research to assess the efficacy and safety of the devices.²⁶
• There is evidence to suggest that the industry’s approach does not guarantee good quality research or prevent the industry from using strategies to influence science. A 2022 systematic review by TCRG found that clinical trials assessing the harms of heated tobacco products (HTPs) “fall short of what is needed to determine whether HTPs are beneficial to public health meaning they may not be a sound basis for tobacco control policy decisions”.²⁷ Of the 40 trials assessed, 29 were tobacco industry affiliated.²⁷ The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) calls for regulatory decisions on tobacco products and the scientific assessment of tobacco products to be made independent of the tobacco industry.

For more information on these and other similar examples see:

Industry Approaches to Science on Newer Products and Tobacco Company Science Pages

See also Harm Reduction: A Tobacco Solution to a Tobacco Problem?

Examples of tobacco companies discrediting research

Tobacco companies have discredited unfavourable research which threatens their profits. For more information on this topic see the landing page: Manufacture trust in industry and its scientific messaging.

• In the 1990s, when regulation of second-hand smoke was being discussed, the industry wanted to discredit science that suggested second-hand smoke was a health risk. PR company APCO Associates set up a front group called The Advancement of Sound Science Coalition (TASSC) in 1994 to discredit the science of second-hand smoke by labelling it as “junk science”. Simultaneously it promoted industry friendly science as “sound science”.²⁸
• In a 2020 report, Philip Morris International, again referred to “junk science”, this time saying it was being used to “set political agendas” and that “poor-quality science is being used to sway the public against alternatives to cigarettes”.²⁹ This same report describe the dangers of “bad science” referring to issues such as vaccine scepticism and scientific illiteracy among policymakers. In this way PMI aligns tobacco industry scientific interests with reasonable public health concern, to try to build trust and credibility.³⁰
• In a 2023 report the Institute of Economic Affairs disregarded data published by the UK’s Department of Health the year before in to how much smoking costs the NHS, saying that “The reality is that smokers pay far more in tobacco duty than they cost the state in healthcare, while non-smokers cost the state more, on average, in both healthcare and social security payments”.³¹ For more on this visit the page Tobacco Industry Interference with Endgame Policies.

Examples of attacks on science and scientists

The tobacco industry also uses intimidation as a tactic to combat unfavourable research.

• Lawsuits in 2012 against Imperial Tobacco Canada (owned by BAT) revealed that in the 1970s the company made explicit efforts to undermine scientific research that proved smoking causes cancer, with Imperial’s PR representative saying that they “should denounce [the findings] with vigor and try to discredit them as much as possible.”³² For more on this see Influencing Science: Imperial Tobacco Canada.
• A 2023 TCRG study illustrated the various forms of intimidation experienced by researchers and advocates working in tobacco control – this intimidation included reputational attacks, physical threats and the use of “vexatious” freedom of information requests.³³
• In 2009 and 2011 the University of Stirling received freedom of information (FOI) requests, on behalf of Philip Morris, attempting to access research data that had informed the UK government’s plain packaging legislation and tobacco display ban. For more information visit the FOI: Stirling University page and the Linda Bauld page.

Example of influencing the publication of science

The tobacco industry also uses various methods to try to ensure that the publication process works in its favour. For more on this topic visit How science is conducted and published to skew evidence in industry’s favour.

Preprints are academic findings published without peer review, unlike traditional journal manuscripts. Platforms that publish preprints, such as medRxiv, can be a helpful way of sharing scientific findings that are time sensitive, and therefore grew in popularity during the COVID-19 pandemic. However, lack of peer review oversight presents an opportunity for tobacco companies to influence the publication of science by publishing industry friendly research that may be rejected by peer-reviewed journals.³⁴

For example:

• During the COVID-19 pandemic several pre-print research articles were published that indicated tobacco may be protective against coronavirus. Some of the authors of these articles had historical links to the tobacco industry, and some of their papers in peer-reviewed journals had been retracted due to these conflicts of interest.³⁴
  For more on retractions and preprints see Tobacco Industry involvement in COVID-19 science
• FSFW and its grantees also use preprint platforms to publish research.¹⁸

Examples of involvement in scientific communities, meetings and events

Tobacco companies view scientific conferences and meetings as useful opportunities to influence science, in some cases by manufacturing controversy about scientific issues.³⁵

• A 2023 TCRG study found that BAT and PMI attended 213 scientific events between 2012 and 2021. Topics covered included Medicine, Biology, Chemistry, Dentistry and Pharmaceutical Science.³⁶
• During the COVID-19 pandemic tobacco companies saw an opportunity to align with public health messaging through health related corporate social responsibility (CSR) initiatives. For example, in April 2021 PMI co-organised an event on “Science Diplomacy” with Foreign Policy magazine that sought to “energize international cooperation on science and technology innovation to tackle misinformation” relating to the pandemic, despite PMI’s history of influencing science for profit.³⁷ For more on tobacco company activities during the pandemic see COVID-19.

Tobacco company science pages

The ‘Big Four’ tobacco companies each present their scientific outputs and research agendas on science websites. Each site is representative of the company’s brand and the sort of scientific image it wants to present to consumers.

• British American Tobacco presents its science via its BAT Science website, which leads with the slogan “A Better Tomorrow”. The site highlights BAT’s research focus in to what it calls “New Category” products as well as its research and commercial interests in vaccine development via its subsidiary Kentucky Bioprocessing.³⁸ During the COVID-19 pandemic Kentucky Bioprocessing began developing a COVID-19 vaccine. For more on this visit Tobacco Company Investments in Pharmaceutical & NRT Products. BAT’s website also features a library of scientific publications.
• Imperial Brands presents its scientific outputs via its Imperial Brands Science It highlights its “Next Generation products” and the product safety testing it conducts using its Scientific Assessment Framework.³⁹ The site also features a research archive.
• Japan Tobacco International (JTI) presents its science via the JT Science website, where it highlights its mission to “inform, educate and collaborate with all those interested in learning about the science behind Reduced-Risk Products (RRP)”. Like Imperial brands, JTI presents a six-step safety assessment for its newer nicotine products.⁴⁰ It also has a section on the science of nicotine and a resource hub archive of JTI research.Alongside its main tobacco business Japan Tobacco Inc., parent company of JTI, has a large pharmaceutical division established in 1987,⁴¹ which researches, develops, manufactures and distributes drugs for a range of diseases including heart disease and cancer.⁴²
• Philip Morris International presents its scientific agenda via the PMI Science The majority of the research it presents is focussed on its heated tobacco product IQOS. The site features a letter from Chief Life Sciences Officer Badrul Chowdhury describing how the company has “spent years disrupting its core cigarette business by developing, assessing and marketing non-combustible alternatives to cigarettes.”.⁴³ The site also features a library of PMI publications.

For more information on this topic visit Industry Approaches to Science on Newer Products.

Tobacco Tactics Resources

• Influencing Science
• Influencing Science: Philip Morris Changing the Conclusions of Research
• Influencing Science: Ghost Writing
• Influencing Science: Imperial Tobacco Canada
• Influencing Science: The Whitecoat Project
• Foundation for a Smoke-Free World
• Foundation for a Smoke-Free World Grantees
• Industry Approaches to Science on Newer Products
• COVID-19
• Cigarette Filters
• Tobacco Company Investments in Pharmaceutical & NRT Products

See the list of pages in the category Influencing Science

TCRG Research

Document analysis of the Foundation for a Smoke-Free World’s scientific outputs and activities: a case study in contemporary tobacco industry agnogenesis, T. Legg, B.  Clift, A.B. Gilmore, Tobacco Control, Published Online First: 03 May 2023. doi: 10.1136/tc-2022-057667

The Science for Profit Model—How and why corporations influence science and the use of science in policy and practice, T. Legg, J. Hatchard and A.B. Gilmore, Plos One, 2021, 16(6):e0253272, doi:10.1371/journal.pone.0253272

Paying lip service to publication ethics: scientific publishing practices and the Foundation for a Smoke-Free World, T. Legg, M. Legendre, A. B. Gilmore, Tobacco Control 2021;30:e65-e72, accessed October 2023

“They try to suppress us, but we should be louder”: a qualitative exploration of intimidation in tobacco control, B.K. Matthes, R. Alebshehy, A.B. Gilmore, Globalization & Health, 19:88,  2023, doi: 10.1186/s12992-023-00991-0.

Seeking to be seen as legitimate members of the scientific community? An analysis of British American Tobacco and Philip Morris International’s involvement in scientific events, B. K. Matthes, A. Fabbri, S. Dance, L. Laurence, K. Silver, A. B. Gilmore. Tobacco Control Published Online First: 03 February 2023. doi: 10.1136/tc-2022-057809

The perils of preprints, M. C. van Schalkwyk, T. R. Hird, N. Maani, M. Petticrew, A. B. Gilmore,  BMJ, 2020; doi:10.1136/bmj.m3111

References

The post Influencing Science Case Studies appeared first on TobaccoTactics.

Background

Previously, Gervais worked for 10 years on trade and intellectual property policy issues as a legal officer at the World Trade Organization (WTO).D.J. Gervais, Daniel Gervais Curriculum Vitae, undated, accessed September 2018
He was also the Editor-in-Chief of the peer-reviewed Journal of World Intellectual Property from 2006 to 2017. Editorial Board, Journal of World Intellectual Property, 2018, accessed September 2018 D.J. Gervais, Daniel Gervais Curriculum Vitae, undated, accessed September 2018
In 2008 Gervais set up the blog TRIPSagreement.net. D.J. Gervais, About the Editor, 2008, accessed September 2018
In 1997 he served as a consultant for the Organisation for Economic Cooperation and Development (OECD).

Relationship with the Tobacco Industry

Authored Plain Packaging Legal Opinion Funded by Japan Tobacco

In November 2010, Gervais authored a legal opinion funded by Japan Tobacco International (JTI) on tobacco plain packaging and the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement. D.J. Gervais, Analysis of the Compatibility of certain Tobacco Product Packaging Rules with the TRIPS Agreement and the Paris Convention, 30 November 2010, accessed September 2018
TRIPS is an international legal agreement about intellectual property rights between all Member States of the World Trade Organization (WTO).
In the legal opinion, Gervais argued that plain packaging is “expected to be found incompatible with TRIPS”:

‘‘A plain packaging measure (as described in this report) would be an encumbrance by special requirement within the meaning of TRIPS Article 20. To the extent that the WTO Member cannot justify that measure, by satisfying the burden of showing (in light of relevant evidence) that a plain packaging measure will achieve its legitimate public policy objectives, the measure can be expected to be found incompatible with TRIPS’’.

Whilst acknowledging that the report was funded by JTI, Gervais claimed that the report “aims to present a neutral view” and was based on his “personal views and analysis”.
Gervais’ legal opinion was included in JTI’s 2012 ‘’Response to the Department of Health’s Consultation on the Standardised Packaging of Tobacco Products’’,⁴⁴ to support the claim that plain packaging is not compatible with the international trade rules of the WTO.

Gervais’ Opinion Not Shared by WTO

In June 2018 the WTO, however, ruled that plain packaging in Australia “does not violate the country’s obligations” under the WTO.⁴⁵⁴⁶
In response to the WTO’s ruling, the World Health Organization (WHO) commented that ‘’The ruling clears another legal hurdle thrown up in the tobacco industry’s efforts to block tobacco control and is likely to accelerate implementation of plain packaging around the globe.’’

Other Work on Plain Packaging

Gervais has authored other work that has touched on the legality of the plain packaging policy, most notably a book called The TRIPS Agreement: Drafting History and Analysis, first published in November 2008.⁴⁷ In the book Gervais wrote “more generally, a plain packaging measure completely ignores the balance that TRIPs, according to its preamble, seeks to establish between the private rights of intellectual property owners and the public interest’.
Law firm LALIVE, who in July 2009 helped Philip Morris International draw up legal concerns with plain packaging, drew extensively from Gervais’ book.⁴⁸

TobaccoTactics Resources

• Plain Packaging in the UK
• Plain Packaging in the UK: Tobacco Industry Funded Research, Expert Opinion and Public Relations
• Plain Packaging in the UK: TCRG Research on Policy Opposition 2011-2013
• Countering Industry Arguments Against Plain Packaging: It Breaches Intellectual Property Rights

References

The post Professor Daniel Gervais appeared first on TobaccoTactics.

Meanwhile the range of products available continues to grow. TobaccoTactics focuses mainly on the products in which the large transnational tobacco companies (TTCs) have developed an interest since the early 2000s. We refer to them collectively as ‘newer nicotine and tobacco products’.

There is an ongoing scientific and policy debate about the role of these products in tobacco control, and whether they can help reduce the harms of tobacco. This page explores the concepts and issues around the topic and links to relevant pages on TobaccoTactics, research by the Tobacco Control Research Group (TCRG), and resources for further reading.

What is Harm Reduction?

The concept of harm reduction, first used in relation to illicit drugs, refers to policies and programmes which aim to reduce the harm from addictive behaviours for individuals, and the community and society in which they live.^50515253 Harm reduction recognises that, while the preferred goal is abstinence, this is not always achievable. Helping people change to less harmful alternatives may be a more effective approach.⁵¹⁵² It therefore primarily aims to reduce drug-related harm rather than drug use.⁵³

Tobacco Harm Reduction

The concept of tobacco harm reduction (THR) refers to reducing the levels of disease (morbidity) and death (mortality) from tobacco use among smokers. While eliminating exposure to nicotine altogether would result in the greatest reduction of harm, THR recognises that this is not always achievable, and users may not always be able or willing to quit. So THR advocates, as its primary goal, that users switch to using nicotine in its less harmful forms.

People smoke primarily because they are addicted to nicotine, but it is the other toxins in tobacco smoke that cause most of the harm. Nicotine can be obtained from a range of products, which vary in their level of harm and addictiveness. This “spectrum of harm” ranges from conventional smoked tobacco (cigarettes) at the top, to medicinal nicotine (nicotine replacement therapy, or NRT) at the bottom.⁵⁴⁵⁵

It is hard to determine the exact position of other products in this spectrum, especially their long-term effects on health. With a longer history of use in Scandinavia and the US, there has been research into the relative harms of snus for a number of years. It would generally be placed at the lower end of the spectrum.⁵⁶

More recently there has been considerable research around the potential role of e-cigarettes, and some evidence that they might help individual smokers quit cigarettes. However,  they are not harm free and there are concerns around youth uptake and dual use with with new and conventional tobacco products.^575859606162

The research around newer heated tobacco products (HTPs) is much less developed.⁵⁹⁶³⁶⁴ While there is some independent evidence of reduced exposure to harmful chemicals from these products, there is currently no independent evidence that HTPs are less harmful than cigarettes, in terms of reduced disease or mortality. There is also no reliable evidence that they help people stop smoking cigarettes. The UK Cochrane review, published in January 2022, found that to date all randomised control trials (RCTs) assessing safety had been funded by tobacco companies. Of the eleven trials eight were “at unclear risk of bias and three at high risk.”⁶⁵ The reviewers concluded that: “Independently funded research on the effectiveness and safety of HTPs is needed.”⁶⁵

For individual smokers, quitting entirely is the best option for reducing harm. If smokers are not able to quit, the risk of disease from tobacco use can be reduced by switching completely to a genuinely less harmful product. Continuing to smoke cigarettes alongside other tobacco or nicotine products would not lead to the same health benefits.

Reducing Harm at Population Level

Although there is no single definition of harm reduction, it is generally acknowledged that it needs to reduce harm not only for the individual user but for the community and society in which they live.⁶⁶⁶⁷ In tobacco harm reduction, therefore, it is necessary to consider the impacts on the whole population rather than just those who currently smoke.⁶⁸

A product might enable some smokers to quit or reduce their risk of disease. But if it still increases population level of harm, it cannot be considered as harm-reducing; for example if a large numbers of non-smokers took up the use of tobacco products; continued to smoke rather than quit; or continued to smoke cigarettes and use other products at the same time (dual or poly/multi use).^6970717273

Although individual smokers who switch fully to less harmful products can reduce their health risks, that does not mean that the introduction of one or more newer products in a country will lead to reduced harm at a population level.^74757677 This would depend on which products are available, whether they enable smokers to quit, and if they are genuinely lower risk than combustibles. It also depends on how they are used. If they are primarily taken up by smokers to quit, or by those who would otherwise have started smoking, this would help reduce overall levels of smoking and therefore reduce harm in the population. However, if they are taken up by people who have not used the products before (sometimes called “nicotine naïve” consumers), including children, this could lead to an increase in smoking, and increase harm.^787980818283

A summary of these issues is provided by the National Academies of Sciences.⁶¹

Particular concerns about the potential for population benefit have been expressed by healthcare professionals, policy makers and tobacco control advocates low and middle-income countries (LMICs).⁸⁴⁸⁵⁸⁶

The impact at population (or country) level also depends on other inter-related factors, including:

• the strength and enforcement of regulation controlling the product itself (e.g. its nicotine content and formulation as well as its price, promotion and availability)
• the behaviour of the companies selling tobacco and newer products: for example whether and how they market to youth, or circumvent regulation, such as smoke-free policies
• the strength and enforcement of tobacco control regulation more generally (i.e. FCTC measures)
• the degree of tobacco company interference, and the ability to counter it

Overall, quitting smoking entirely remains the best option both for individual smokers and from a public health perspective.

• For up to date information on tobacco regulation, see the Tobacco Control Laws website, published by the Campaign for Tobacco Free Kids (CTFK).
• Information on the regulation of specific products can be found on the pages linked below.
• For information on tobacco companies’ interference in tobacco control, see the Global Tobacco Industry Interference Index.

The Role of the Tobacco Industry

Tobacco harm reduction has become controversial and, some feel, divisive in public health, in particular where the debate has focussed on the potential role for other nicotine and tobacco products such as e-cigarettes and snus.^56878889

• See the list of TobaccoTactics Resources below for links to pages on the various products made and sold by tobacco companies.

One of the reasons harm reduction is a sensitive topic is that it can involve engagement with the tobacco industry, which has a history of manipulating public debate and health policy.

A History of Misinformation and Manipulation

In the 1960s and 1970s, public health scientists and officials in the US and UK encouraged smokers to switch to low-tar and low-nicotine cigarette brands.  They had been persuaded by an apparent commitment by tobacco companies to develop a “less hazardous cigarette”.⁹⁰⁹¹ However, the tobacco industry concealed its own research which showed that these modified products would lead to ‘compensatory’ smoking behaviours (such as inhaling more strongly or taking more frequent puffs) and not in fact reduce the harms of smoking.⁹⁰⁹²⁹³

In the 1990s harm reduction claims were also made for early ‘heat not burn’ tobacco products, although these were not commercially successful at the time.⁹²

Historians of public health have warned that, given the tobacco industry’s past misleading use of harm reduction claims to further its commercial and policy goals, THR strategies need to be approached with care and be supported by robust scientific evidence.^93949596

The Industry’s Real Motive

In one word: profit. While tobacco companies continue to sell and promote their conventional products, global cigarette sales are decreasing.⁹⁷

Tobacco companies have invested in, developed and promoted newer nicotine and tobacco products in the hope that this will prevent smokers from quitting entirely and attract new users. Ultimately, the aim is to offset the diminishing profits from conventional tobacco products. However, the main driver for tobacco company growth is still cigarettes; and this is likely to continue to be the case for the foreseeable future.⁸⁷⁹⁷⁹⁸

Evidence shows that the tobacco industry has never been genuinely interested in reducing harm. Its activities are primarily designed to serve its commercial objectives, in a variety of ways:

• by claiming a commitment to harm reduction, and attempt to improve its reputation. This can be seen as an attempt to “‘renormalise’ an industry that wants to be seen as a responsible business with a legitimate product”.^87979899
• by using newer products as tools to initiate dialogue with scientists, public health experts, politicians and policy makers, re-framing the industry as ‘part of the solution’ rather than being responsible for the problem. It continues to try to re-enter the policy arena from which it has increasingly, and successfully, been excluded (see below), to gain a ‘seat at the table’.⁹⁷⁹⁸
• by attempting to weaken and undermine tobacco control regulations. Nearly a decade after the promotion of snus as a dual use product, tobacco companies are following the same strategy. British American Tobacco (BAT) has referred to the “additive opportunity” of newer products ; a way to gain both new nicotine users and give smokers “new consumption moments”, including in restaurants and other places where smoking is banned.⁸⁷¹⁰⁰ Philip Morris International (PMI) has promoted “IQOS friendly places” including hotels, clubs and other public spaces, where people can use HTPs despite smoking bans.¹⁰¹ The tobacco industry’s fundamental conflict of interest should prevent it from influencing the regulation of newer products.
• as a tactic to divide the public health community.^9497102

Research shows that the industry uses different public narratives in its investor-facing and public-facing materials, which serve to mislead and distract from the harms of its products.¹⁰³¹⁰⁴ Companies emphasise individual factors like consumer choice, and downplay the addictiveness of their products, and both individual and population level harms.¹⁰³¹⁰⁴ Large transnational companies:

“seek to normalize their role in public discussions of health policy, to cast themselves as instrumental in the redress of tobacco-related inequalities and shift responsibility for the continuation of tobacco-product use onto individual consumers.” ¹⁰⁴

Meanwhile conventional cigarettes remain key to tobacco companies’ business models.

The main barrier to achieving public health benefits from harm reduction approaches is the behaviour of the tobacco industry. There is a fundamental conflict of interest between tobacco companies’ interests and public health. This is enshrined in the World Health Organization’s (WHO) Framework Convention for Tobacco Control (FCTC).  FCTC Article 5.3 requires the exclusion of the tobacco industry and its front groups from policy making. As the tobacco industry manipulates debates over harm reduction for policy advantage, Article 5.3 applies to those producers of newer products who are part of the tobacco industry, and the third party organisations lobbying on its behalf.⁹⁷⁹⁸

Industry-Funded Research

The tobacco industry attempts to influence the scientific debates around newer products and harm reduction. Research into these products and their impacts, at both individual and population level, is essential. The tobacco industry has a clear vested interest in showing that their products are safe, but it has a  history of manipulating the science around cigarettes.^105106107 It has also done this via third parties.¹⁰⁸¹⁰⁹

Evidence is beginning to emerge indicating that we should also be concerned about the industry’s newer products science,¹¹⁰¹¹¹ particularly its heavy involvement in heated tobacco product science.^596364110

Researchers from the Center for Tobacco Control Research at UCSF found that articles funded by the tobacco industry favoured harm reduction, while non-industry-funded articles, were “evenly divided in stance”.¹¹² They also found a lack of empirical research, with more of the debate conducted in ‘opinion pieces’.¹¹³

A number of scientists influencing the debate on harm reduction or newer products are funded by the tobacco industry. Examples on TobaccoTactics include:

• Jed E. Rose is director of the Center for Smoking Cessation Research (CSCR) at Duke University in the USA, an institution with a long history of tobacco money. He is the inventor of the nicotine patch, and a nicotine aerosol technology. The Center, his research and his career are closely interlinked with the tobacco industry, more specifically Philip Morris (Philip Morris International, and previously Philip Morris USA which is now Altria owned).  The story on Duke University and the Tobacco Industry shows Philip Morris actively promoting the nicotine patch as a quitting strategy, with the research funded by the company and with the endorsement of scientists involved.
• Brad Rodu is a Professor of Medicine at the University of Louisville, whose work is funded by unrestricted grants from Swedish Match, Reynolds American, Altria and British American Tobacco.
• Carl V Phillips was hired by U.S. Smokeless Tobacco Company as an expert witness to deny any causal association between Smokeless Tobacco and oral- or tongue cancer.
• Riccardo Polosa is an Italian scientist who conducted a clinical trial for e-cigarettes and was also involved in marketing them as a cessation therapy. The page E-cigarettes: Mixing Research and Marketing details how his institute was founded with Philip Morris money.
• The Foundation for a Smoke-Free World (FSFW) funds research and advocacy around newer products products – while being fully-funded by Philip Morris International. Many of FSFW’s grantees , and researchers in its Centers of Excellence, are active in harm reduction advocacy.

It has been argued that the best way to ensure independent science in this area is through a tax on tobacco companies.¹¹⁴ Until that happens, care must be taken when interpreting research funded directly – or indirectly – by the tobacco industry.

Implications for Global Tobacco Control

The WHO has published guidelines on newer products and their regulation. An information sheet on HTPs was released in July 2018, recommending that “HTPs should be subject to the same policy and regulatory measures applied to all other tobacco products” in line with the FCTC.¹¹⁵

In March 2019, the Secretariat of the WHO FCTC issued an information note, which compiled all Conference of the Parties (COP) decisions related to e-cigarettes. A few months later, the Secretariat released a statement urging governments to remain vigilant, stating that:

“novel and emerging nicotine and tobacco products…are creating another layer of interference by the tobacco industry and related industries, which is still reported by Parties as the most serious barrier to progress in implementing the WHO FCTC”. ¹¹⁶ It also reminded Parties of their obligations under Article 5.3 to protect tobacco control policies and activities from all commercial and vested interests.¹¹⁶

According to the editor of the journal Tobacco Control, tobacco companies:

“continue to work to interject themselves into activities promoted under the WHO Framework Convention on Tobacco Control (FCTC), particularly criticising Article 5.3, which seeks to protect public health policy-making from their commercial interests, and why their allies seek to pressure and undermine the WHO.”¹¹⁷

The global tobacco control priority remains the implementation of comprehensive, evidence-based, well-enforced population level policies. As outlined in the FCTC these aim to reduce the uptake of smoking by young people and prompt smokers to quit. They include policies such as tobacco tax increases, bans on promotion, restrictions on availability, and the implementation of WHO FCTC Article 5.3. Any harm reduction approaches should be implemented as part of a broader strategy, including a comprehensive range of well enforced tobacco control policies.

The Tobacco Control Research Group states that:

“The tobacco industry, and its front groups, should not be treated as legitimate partners in any discussions on tobacco control policies and approaches, including harm reduction, or in research on NNTPs [novel nicotine and tobacco products].”¹⁰²

For more information on how the tobacco industry works through its front groups and other allies see the page: Third Party Techniques.

Tobacco Endgame

In some countries (such as New Zealand and Canada) ‘endgame’ approaches to creating a tobacco- and nicotine-free future are increasingly being discussed, for example de-nicotinising tobacco products. Endgame approaches are diverse.¹¹⁸¹¹⁹ They may include a role for genuinely reduced risk products to be used as quitting aids and/or alternative products to cigarettes.^120121122123

• For more information see Tobacco Industry Interference with Endgame Policies

TobaccoTactics Resources

The Newer Nicotine and Tobacco Products page gives an overview of transnational tobacco companies’ interests and products, and links to more detailed pages for each company. The page contains a graphic overview of key tobacco company brands.

The following pages give more detail on the product types, and link back to tobacco company product pages:

• E-cigarettes
• Heated Tobacco Products
• Smokeless Tobacco, Snus & related products
  • Cigarette Companies Investing in Snus
  • Snus: EU Ban on Snus Sales
  • Nicotine Pouches
• Nicotine Replacement Therapy;
  • For Philip Morris promoting QuitAssist, a nicotine patch as a quitting strategy, see the page on Duke University and the Tobacco Industry
  • See Kind Consumer for BAT’s early interest in a nicotine inhaler
  • For other products,  see Tobacco Company Investments in Pharmaceutical and NRT Products

See also Product Innovation as a tobacco company strategy.

List of pages in the category Harm Reduction.

Tobacco Industry Product Terminology page – also covers conventional and traditional products.

Read more about Tobacco Industry Tactics

Relevant Links

• Addiction at any cost. Philip Morris International uncovered, STOP, 2020, available from exposetobacco.org
• TCRG statement on novel nicotine and tobacco products

TCRG Research

Identifying misleading corporate narratives: The application of linguistic and qualitative methods to commercial determinants of health research, I. Fitzpatrick , A. Bertscher, A.B. Gilmore, PLOS Global Public Health, 16 November 2022, doi:10.1371/journal.pgph.0000379

Tobacco industry messaging around harm: Narrative framing in PMI and BAT press releases and annual reports 2011 to 2021, I. Fitzpatrick, S. Dance, K. Silver, M. Violini, T.R. Hird, Frontiers in Public Health, 18 October 2022, doi:10.3389/fpubh.2022.958354

Understanding the emergence of the tobacco industry’s use of the term tobacco harm reduction in order to inform public health policy, S. Peeters, A.B. Gilmore, Tobacco Control, 2015;24:182-189

E-cigarettes: threat or opportunity?, A.B. Gilmore, G.E. Hartwell, European Journal of Public Health, 2014, 24(4):532-3. doi:10.1093/eurpub/cku085

For a comprehensive list of all TCRG publications, including TCRG research that evaluates the impact of public health policy, go to the Bath TCRG’s list of publications.

References

The post Harm Reduction appeared first on TobaccoTactics.

The Institute has a long association with the tobacco industry and echoes its arguments in a number of areas through policy briefs, lobbying and media appearances.

Funding

Its 2018 annual report said that it received $5.8m in funding of which 70% came from individuals, 22% from foundations and 6% from corporations.¹²⁷ However the institute says that due to attacks by critics it no longer publishes a list of its donors. It adds that it has procedures in place to “protect our writers and editors from undue influence by donors”.¹²⁸

Nonetheless, tobacco industry funding stretches back to at least the 1990s. Roy Marden, Philip Morris International’s then manager of industry affairs, received a letter from Heartland president Joseph Blast in 1999. Blast hoped that PMI would increase the $30,000 it gave the previous year. Blast wrote: “Heartland has devoted considerable attention to defending tobacco (and other industries) from what I view as being an unjust campaign of public demonization and legal harassment. We’re an important voice defending smokers and their freedom to use a still-legal product.” ¹²⁹ Tobacco company Altria is known to have donated to the Institute in 2011, and annually from 2013 to 2016.¹³⁰

“Consumer Freedom Lounge”

The Institute has a dedicated area on its website, called the ‘Consumer Freedom Lounge’, to promote its thinking on alcohol and smoking. It says that it is the “place to go for sound science, economics, and legal commentary on tobacco issues”.¹³¹ In this area it has published a number of articles challenging the science around second-hand smoke, arguing against smoking bans and tax increases and supporting e-cigarettes.
Under the heading ‘Tobacco Control’ it states that:

“government regulators have gone well beyond reasonable measures to discourage smoking and protect nonsmokers, and they are now waging all-out war on smokers. That’s wrong. Federal, state, and local government in the United States have used excise taxes, smoking bans, and other regulations in an attempt discourage cigarette use, but those are having little effect on smoking rates.”¹³¹

This section has resources to support lobbying around tobacco issues including policy briefs such as Five Things to Consider Before Raising Tobacco Taxes This states that taxation is more burdensome to poorer people, that tobacco tax increases lead to an increase in “black market” or illicit tobacco, and that they might reduce government revenue. All are arguments commonly used by the tobacco industry.¹³²

The ‘Consumer Freedom Lounge’ hosts a video in which Brad Rodu “discuss vaping from a scientific and industry perspective”. Rodu is Professor of Medicine at the University of Louisville and has a blog called Tobacco Truth. Some of his research has been funded by tobacco companies and has been openly declared as such.¹³³

Lobbying on E-Cigarettes

A regular writer for Heartland on e-cigarette and vaping issues is Lindsey Stroud. She joined the organisation in 2016 having worked for various politicians. In 2017 she became the Institute’s State Government Relations Manager.¹³⁴

Stroud regularly argues for loosening regulations around e-cigarettes.¹³⁵. She is a board member of THR4Life , a tobacco ‘harm reduction’ lobby group registered as a charity which has lobbied the WHO on e-cig regulations¹³⁶ and the US  Food and Drug Administration.¹³⁷

Relevant TobaccoTactics Resources

• Think Tanks
• Tobacco Industry Arguments Against Taxation
• Harm Reduction
• E-cigarettes

TCRG Research

Visit Tobacco Control Research Group: Peer-Reviewed Research for a full list of our journal articles of tobacco industry influence on health policy.

References

The post Heartland Institute appeared first on TobaccoTactics.